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. 2022 Apr;175(4):556-565.
doi: 10.7326/M21-3272. Epub 2022 Jan 25.

What Is the Antibody Response and Role in Conferring Natural Immunity After SARS-CoV-2 Infection? Rapid, Living Practice Points From the American College of Physicians (Version 2)

Amir Qaseem  1 , Jennifer Yost  2 , Itziar Etxeandia-Ikobaltzeta  1 , Mary Ann Forciea  3 , George M Abraham  4 , Matthew C Miller  5 , Adam J Obley  6 , Linda L Humphrey  6 ; Scientific Medical Policy Committee of the American College of Physicians*; Elie A Akl, Rebecca Andrews, Andrew Dunn, Ray Haeme, Devan L Kansagara, Mark P Tschanz; Scientific Medical Policy Committee of the American College of Physicians
Collaborators, Affiliations

What Is the Antibody Response and Role in Conferring Natural Immunity After SARS-CoV-2 Infection? Rapid, Living Practice Points From the American College of Physicians (Version 2)

Amir Qaseem et al. Ann Intern Med. 2022 Apr.

Abstract

Description: The Scientific Medical Policy Committee (SMPC) of the American College of Physicians (ACP) developed these living, rapid practice points to summarize the current best available evidence on the antibody response to SARS-CoV-2 infection and protection against reinfection with SARS-CoV-2. This is version 2 of the ACP practice points, which serves to update version 1, published on 16 March 2021. These practice points do not evaluate vaccine-acquired immunity or cellular immunity.

Methods: The SMPC developed this version of the living, rapid practice points based on an updated living, rapid, systematic review conducted by the Portland VA Research Foundation and funded by the Agency for Healthcare Research and Quality.

Practice point 1: Do not use SARS-CoV-2 antibody tests for the diagnosis of SARS-CoV-2 infection.

Practice point 2: Do not use SARS-CoV-2 antibody tests to predict the degree or duration of natural immunity conferred by antibodies against reinfection, including natural immunity against different variants.

Retirement from living status: Although natural immunity remains a topic of scientific interest, this topic is being retired from living status given the availability of effective vaccines for SARS-CoV-2 and widespread recommendations for and prevalence of their use. Currently, vaccination is the best clinical recommendation for preventing infection, reinfection, and serious illness from SARS-CoV-2 and its variants.

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Conflict of interest statement

Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-3272. All financial and intellectual disclosures of interest were declared, and potential conflicts were discussed and managed. Dr. Jokela participated in discussion of the practice points but was recused from authorship and voting due to a moderate-level conflict of interest (authored recent relevant publications). Dr. Marcucci participated in the discussion of the practice points but was recused from authorship and voting due to a moderate-level conflict of interest (author of relevant systematic review). A record of disclosures of interest and management of conflicts is kept for each SMPC meeting and conference call and can be viewed at www.acponline.org/about-acp/who-we-are/leadership/boards-committees-councils/scientific-medical-policy-committee/disclosure-of-interests-and-conflict-of-interest-management-summary-for-scientific-medical-policy.

Figures

Figure.
Figure.. Evidence description.
The evidence search and assessment were conducted by the Portland VA Research Foundation (3, 5, 6). The evidence search was updated through 22 September 2021. PCR = polymerase chain reaction. * Observational studies include studies estimating seroprevalence among a given population that includes a small subpopulation known to have SARS-CoV-2 infection; cross-sectional or cohort studies characterizing the antibody response among adults with SARS-CoV-2 infection; and large, population-based observational (cohort, case–control) studies comparing risk for reinfection in adults with and without recent SARS-CoV-2 infection (3,5,6). Immunoassay validation studies include those validating the diagnostic performance of 1 or more immunoassays (3).
See this image and copyright information in PMC

Update of

References

    1. Advisory Committee on Immunization Practices. COVID-19 ACIP Vaccine Recommendations. Accessed at www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/covid-19.html on 1 December 2021.
    1. World Health Organization. COVID-19 advice for the public: Getting vaccinated. Accessed at www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccine... on 1 December 2021.
    1. Arkhipova-Jenkins I, Helfand M, Armstrong C, et al. Antibody response after SARS-CoV-2 infection and implications for immunity: a rapid living review. Ann Intern Med. 2021;174:811-21. [PMID: ] doi:10.7326/M20-7547 - DOI - PMC - PubMed
    1. Qaseem A, Yost J, Etxeandia-Ikobaltzeta I, et al; Scientific Medical Policy Committee of the American College of Physicians. What is the antibody response and role in conferring natural immunity after SARS-CoV-2 infection? Rapid, living practice points from the American College of Physicians (version 1). Ann Intern Med. 2021;174:828-35. [PMID: ] doi:10.7326/M20-7569 - DOI - PMC - PubMed
    1. Helfand M, Fiordalisi C, Wiedrick J, et al. Risk of reinfection after SARS-CoV-2. Living rapid review for ACP practice points on the role of the antibody response in conferring immunity following SARS-CoV-2 infection. Ann Intern Med. 25 January 2022. [Epub ahead of print]. doi:10.7326/M21-4245 - PMC - PubMed